Provider Demographics
NPI:1568982213
Name:WILKINS, BRANDY NICOLE
Entity type:Individual
Prefix:MRS
First Name:BRANDY
Middle Name:NICOLE
Last Name:WILKINS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:BRANDY
Other - Middle Name:NICOLE
Other - Last Name:LOWREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10338 E 11TH ST # 105
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74128-3008
Mailing Address - Country:US
Mailing Address - Phone:918-978-3681
Mailing Address - Fax:918-216-9835
Practice Address - Street 1:10338 E 11TH ST # 105
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74128-3008
Practice Address - Country:US
Practice Address - Phone:918-978-3681
Practice Address - Fax:918-216-9835
Is Sole Proprietor?:No
Enumeration Date:2017-06-23
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK041814764Medicaid